Martin Hoenigl, Amir Arastehfar, Maiken Cavling Arendrup, Roger Brüggemann, Agostinho Carvalho, Tom Chiller, Sharon Chen, Matthias Egger, Simon Feys, Jean-Pierre Gangneux, Jeremy A W Gold, Andreas H Groll, Jannes Heylen, Jeffrey D Jenks, Robert Krause, Katrien Lagrou, Frédéric Lamoth, Juergen Prattes, Sarah Sedik, Joost Wauters, Nathan P Wiederhold, George R Thompson
SUMMARYFungal infections are on the rise, driven by a growing population at risk and climate change. Currently available antifungals include only five classes, and their utility and efficacy in antifungal treatment are limited by one or more of innate or acquired resistance in some fungi, poor penetration into "sequestered" sites, and agent-specific side effect which require frequent patient reassessment and monitoring. Agents with novel mechanisms, favorable pharmacokinetic (PK) profiles including good oral bioavailability, and fungicidal mechanism(s) are urgently needed...
April 11, 2024: Clinical Microbiology Reviews
Chin Fen Neoh, Sharon C-A Chen, Fanny Lanternier, Shio Yen Tio, Catriona L Halliday, Sarah E Kidd, David C M Kong, Wieland Meyer, Martin Hoenigl, Monica A Slavin
SUMMARYAlthough Scedosporium species and Lomentospora prolificans are uncommon causes of invasive fungal diseases (IFDs), these infections are associated with high mortality and are costly to treat with a limited armamentarium of antifungal drugs. In light of recent advances, including in the area of new antifungals, the present review provides a timely and updated overview of these IFDs, with a focus on the taxonomy, clinical epidemiology, pathogenesis and host immune response, disease manifestations, diagnosis, antifungal susceptibility, and treatment...
March 29, 2024: Clinical Microbiology Reviews
Eva H Clark, Louisa A Messenger, Jeffrey D Whitman, Caryn Bern
SUMMARYAs Chagas disease remains prevalent in the Americas, it is important that healthcare professionals and researchers are aware of the screening, diagnosis, monitoring, and treatment recommendations for the populations of patients they care for and study. Management of Trypanosoma cruzi infection in immunocompromised hosts is challenging, particularly because, regardless of antitrypanosomal treatment status, immunocompromised patients with Chagas disease are at risk for T. cruzi reactivation, which can be lethal...
March 28, 2024: Clinical Microbiology Reviews
Marisa Ann Azad, Robin Patel
SUMMARYImplant-associated infections (IAIs) pose serious threats to patients and can be associated with significant morbidity and mortality. These infections may be difficult to diagnose due, in part, to biofilm formation on device surfaces, and because even when microbes are found, their clinical significance may be unclear. Despite recent advances in laboratory testing, IAIs remain a diagnostic challenge. From a therapeutic standpoint, many IAIs currently require device removal and prolonged courses of antimicrobial therapy to effect a cure...
March 20, 2024: Clinical Microbiology Reviews
Elitza S Theel, James E Kirby, Nira R Pollock
SUMMARYThe emergence and worldwide dissemination of SARS-CoV-2 required both urgent development of new diagnostic tests and expansion of diagnostic testing capacity on an unprecedented scale. The rapid evolution of technologies that allowed testing to move out of traditional laboratories and into point-of-care testing centers and the home transformed the diagnostic landscape. Four years later, with the end of the formal public health emergency but continued global circulation of the virus, it is important to take a fresh look at available SARS-CoV-2 testing technologies and consider how they should be used going forward...
March 15, 2024: Clinical Microbiology Reviews
Christopher A Mullally, Marhami Fahriani, Shakeel Mowlaboccus, Geoffrey W Coombs
SUMMARYEnterococci are a diverse group of Gram-positive bacteria that are typically found as commensals in humans, animals, and the environment. Occasionally, they may cause clinically relevant diseases such as endocarditis, septicemia, urinary tract infections, and wound infections. The majority of clinical infections in humans are caused by two species: Enterococcus faecium and Enterococcus faecalis . However, there is an increasing number of clinical infections caused by non- faecium non- faecalis (NFF) enterococci...
March 11, 2024: Clinical Microbiology Reviews
Nada Reza, Alessandro Gerada, Katharine E Stott, Alex Howard, Mike Sharland, William Hope
SUMMARYThe World Health Organisation's 2022 AWaRe Book provides guidance for the use of 39 antibiotics to treat 35 infections in primary healthcare and hospital facilities. We review the evidence underpinning suggested dosing regimens. Few ( n = 18) population pharmacokinetic studies exist for key oral AWaRe antibiotics, largely conducted in homogenous and unrepresentative populations hindering robust estimates of drug exposures. Databases of minimum inhibitory concentration distributions are limited, especially for community pathogen-antibiotic combinations...
March 4, 2024: Clinical Microbiology Reviews
Patrick S Creisher, Sabra L Klein
SUMMARYViral infections during pregnancy are associated with significant adverse perinatal and fetal outcomes. Pregnancy is a unique immunologic and physiologic state, which can influence control of virus replication, severity of disease, and vertical transmission. The placenta is the organ of the maternal-fetal interface and provides defense against microbial infection while supporting the semi-allogeneic fetus via tolerogenic immune responses. Some viruses, such as cytomegalovirus, Zika virus, and rubella virus, can breach these defenses, directly infecting the fetus and having long-lasting consequences...
February 29, 2024: Clinical Microbiology Reviews
Stefano Di Bella, Gianfranco Sanson, Jacopo Monticelli, Verena Zerbato, Luigi Principe, Mauro Giuffrè, Giuseppe Pipitone, Roberto Luzzati
SUMMARY Clostridioides difficile infection (CDI) is one of the major issues in nosocomial infections. This bacterium is constantly evolving and poses complex challenges for clinicians, often encountered in real-life scenarios. In the face of CDI, we are increasingly equipped with new therapeutic strategies, such as monoclonal antibodies and live biotherapeutic products, which need to be thoroughly understood to fully harness their benefits. Moreover, interesting options are currently under study for the future, including bacteriophages, vaccines, and antibiotic inhibitors...
February 29, 2024: Clinical Microbiology Reviews
Ilana Nazari, Matthew J Feinstein
SUMMARYPeople with HIV (PWH) are at elevated risk for cardiovascular diseases (CVDs), including myocardial infarction, heart failure, and sudden cardiac death, among other CVD manifestations. Chronic immune dysregulation resulting in persistent inflammation is common among PWH, particularly those with sustained viremia and impaired CD4+ T cell recovery. This inflammatory milieu is a major contributor to CVDs among PWH, in concert with common comorbidities (such as dyslipidemia and smoking) and, to a lesser extent, off-target effects of antiretroviral therapy...
February 1, 2024: Clinical Microbiology Reviews
Emily Puumala, Sara Fallah, Nicole Robbins, Leah E Cowen
SUMMARYOver recent decades, the global burden of fungal disease has expanded dramatically. It is estimated that fungal disease kills approximately 1.5 million individuals annually; however, the true worldwide burden of fungal infection is thought to be higher due to existing gaps in diagnostics and clinical understanding of mycotic disease. The development of resistance to antifungals across diverse pathogenic fungal genera is an increasingly common and devastating phenomenon due to the dearth of available antifungal classes...
January 31, 2024: Clinical Microbiology Reviews
K Storm, C M Durand
SUMMARYThere is a growing need for solid organ transplantation (SOT) for people living with human immunodeficiency virus (HIV). With the advent of antiretroviral therapy, people living with HIV are experiencing increased life expectancies and are, therefore, developing more comorbidities, including end-stage organ disease. In cases of advanced organ failure, SOT is often the best therapeutic option to improve quality of life and overall survival. As organ shortages persist, transplantation of organs from donors with HIV to recipients with HIV has become a potential therapeutic option...
January 19, 2024: Clinical Microbiology Reviews
Dilhan J Perera, Cal Koger-Pease, Kayla Paulini, Mohamed Daoudi, Momar Ndao
SUMMARYSchistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma , co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium , Salmonella , various urinary tract infection-causing agents, and viral pathogens...
March 14, 2024: Clinical Microbiology Reviews
Emily G McDonald, Avideh Afshar, Bander Assiri, Tom Boyles, Jimmy M Hsu, Ninh Khuong, Connor Prosty, Miranda So, Zahra N Sohani, Guillaume Butler-Laporte, Todd C Lee
SUMMARY Pneumocystis jirovecii is a ubiquitous opportunistic fungus that can cause life-threatening pneumonia. People with HIV (PWH) who have low CD4 counts are one of the populations at the greatest risk of Pneumocystis jirovecii pneumonia (PCP). While guidelines have approached the diagnosis, prophylaxis, and management of PCP, the numerous studies of PCP in PWH are dominated by the 1980s and 1990s. As such, most studies have included younger male populations, despite PCP affecting both sexes and a broad age range...
March 14, 2024: Clinical Microbiology Reviews
Eloise Williams, Kate L Seib, Christopher K Fairley, Georgina L Pollock, Jane S Hocking, James S McCarthy, Deborah A Williamson
SUMMARY Neisseria gonorrhoeae infection is an important public health issue, with an annual global incidence of 87 million. N. gonorrhoeae infection causes significant morbidity and can have serious long-term impacts on reproductive and neonatal health and may rarely cause life-threatening disease. Global rates of N. gonorrhoeae infection have increased over the past 20 years. Importantly, rates of antimicrobial resistance to key antimicrobials also continue to increase, with the United States Centers for Disease Control and Prevention identifying drug-resistant N...
March 14, 2024: Clinical Microbiology Reviews
Men-Bao Qian, Jennifer Keiser, Jürg Utzinger, Xiao-Nong Zhou
SUMMARY Clonorchis sinensis , Opisthorchis viverrini , and Opisthorchis felineus are important liver flukes that cause a considerable public health burden in eastern Asia, southeastern Asia, and eastern Europe, respectively. The life cycles are complex, involving humans, animal reservoirs, and two kinds of intermediate hosts. An interplay of biological, cultural, ecological, economic, and social factors drives transmission. Chronic infections are associated with liver and biliary complications, most importantly cholangiocarcinoma...
January 3, 2024: Clinical Microbiology Reviews
Gunnar Kahlmeter, John Turnidge
SUMMARY The characterization of wild-type minimum inhibitory concentration (MIC) and zone diameter distributions with the setting of epidemiological cut-off values (ECOFFs or ECVs) provides a reference for the otherwise relative MIC values in the international system for antimicrobial susceptibility testing. Distributions of MIC values for a species and an agent follow a log-normal distribution, which in the absence of resistance mechanisms is monomodal and designated wild type (WT). The upper end of the WT distribution, the ECOFF, can be identified with statistical methods...
December 20, 2023: Clinical Microbiology Reviews
Simpal Kumar Suman, Natarajan Chandrasekaran, C George Priya Doss
SUMMARYTuberculosis (TB) is a major global health problem and the second most prevalent infectious killer after COVID-19. It is caused by Mycobacterium tuberculosis ( Mtb ) and has become increasingly challenging to treat due to drug resistance. The World Health Organization declared TB a global health emergency in 1993. Drug resistance in TB is driven by mutations in the bacterial genome that can be influenced by prolonged drug exposure and poor patient adherence. The development of drug-resistant forms of TB, such as multidrug resistant, extensively drug resistant, and totally drug resistant, poses significant therapeutic challenges...
December 20, 2023: Clinical Microbiology Reviews
Thomas C McHale, David R Boulware, John Kasibante, Kenneth Ssebambulidde, Caleb P Skipper, Mahsa Abassi
Cryptococcal meningitis is a leading cause of morbidity and mortality globally, especially in people with advanced HIV disease. Cryptococcal meningitis is responsible for nearly 20% of all deaths related to advanced HIV disease, with the burden of disease predominantly experienced by people in resource-limited countries. Major advancements in diagnostics have introduced low-cost, easy-to-use antigen tests with remarkably high sensitivity and specificity. These tests have led to improved diagnostic accuracy and are essential for screening campaigns to reduce the burden of cryptococcosis...
December 20, 2023: Clinical Microbiology Reviews
Jhih-Hang Jiang, David R Cameron, Cara Nethercott, Marta Aires-de-Sousa, Anton Y Peleg
SUMMARYMethicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of severe and often fatal infections. MRSA epidemics have occurred in waves, whereby a previously successful lineage has been replaced by a more fit and better adapted lineage. Selection pressures in both hospital and community settings are not uniform across the globe, which has resulted in geographically distinct epidemiology. This review focuses on the mechanisms that trigger the establishment and maintenance of current, dominant MRSA lineages across the globe...
December 20, 2023: Clinical Microbiology Reviews
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